The spinal column is a highly complex structure which houses and protects critical elements of the nervous system. In spite of these complexities, the spinal column is a highly flexible structure, capable of a high degree of curvature and twist through a wide range motion. Genetic or developmental irregularities, trauma, chronic stress, tumors, and disease, however, can result in spinal pathologies which either limit this range of motion, or threaten the critical elements of the nervous system housed within the spinal column.
A variety of systems has been disclosed in the art which achieve immobilization of portions of the spinal column by implanting artificial assemblies in or on the spinal column. These assemblies may be generally classified as anterior, posterior or lateral implants. Posterior implants are attached to the back of the spinal column generally by coupling to the pedicles with screws, or through hooks that attach under the lamina. In either case, the implants generally include elongate support rod elements which are coupled to the screws or hooks to immobilize two or more sequential vertebrae, for example to hold them stable so that adjacent bones may be fused with bone graft.
During implantation of a spinal fixation system of the type having an elongated support rod and anchors, it is important to provide adjustability between the support rod and the anchors. Adjustability facilitates ideal placement of the bone anchors relative to the spine. Preferably, the adjustability between the support rod and the anchors allows the supports rods to translate relative to the anchors and also allows for pivotal movement of the anchors relative to the support rod. The spinal system must also be able to arrest relative movement between the support rod and the anchors after implantation so that the spinal segments are post-operatively immobilized.
While known spinal fixation systems have proven to be useful for various applications, they are all associated with drawbacks. In this regard, the fixation screws or hooks of most known systems are difficult or impossible to adequately tighten to arrest relative movement between the anchors and support rod after implantation. Overcoming this limitation typically involves a complex clamping arrangement or an arrangement that requires undue tightening. Use of known systems are often a tedious process, which is inconsistent in result and adds unwanted time to a procedure.
Accordingly, it remains a need in the art to provide an improved spinal system clamping mechanism for coupling a rod and a bone anchor that overcomes the above discussed and other drawbacks of the prior art.